BIOETHICS

Baby Bailouts and Benetton Babies

Responsible Use of Reproductive Technologies

Fury about the executives who have received massive compensation even as their companies have had to be bailed out with public funds seems to have trickled over to the disconcerting case of Nadya Suleman, who gave birth to octuplets with the help of a Los Angeles fertility clinic. The LA Times reports that Suleman, the mother of 14 children in total, is now the victim of death threats. Perhaps some of the perpetrators are angry about the prospect that the unemployed Suleman’s many children will ultimately have to be supported by tax dollars.

If so their anger is misplaced. The issue here is not reproductive freedom but the responsibilities of the fertility specialists to make judgments about the appropriateness of assisting a woman who already has children and of implanting so many embryos. As our Science Progress advisory board member (and my UPenn colleague) Art Caplan put it in his typically direct way, “With all due respect, the idea that doctors should not set limits on who can use reproductive technology to make babies is ethically bonkers.”

Rather, public anger should be directed at a fertility industry that puts mothers and babies at risk. One good outcome of this episode could be the American Society for Reproductive Medicine’s investigation of whether the physicians followed its guidelines for in vitro fertilization. A strong statement by the ASRM would act as a warning and seems preferable to legislation, which would be exceedingly difficult to write in a way that did not prejudice tougher cases.

As the saga of the octuplets unfolds, we were struck by a Wall Street Journal report that another LA fertility clinic (what is it about those Angelenos anyway?) is planning to offer the service of testing embryos prior to implantation for traits like gender or hair color. Reading this story, thirty years of teaching and writing about bioethics flashed before my (brown) eyes. Using pre-implantation genetic diagnosis to make babies with various skin tones may make for delightful bus stop advertising but distressing public policy. Advances in genetics, such as the copy number variation technologies described previously in SP, appear to be leading in the direction of fairly complex trait selection, if not in the near future then someday not so far away.

Leaving aside the question of whether the genetics is as far along as the clinic believes (perhaps it will offer a money-back guarantee), progressive politics entails respect for differences. Skeptical as we are about casual slippery slope arguments, practices that implement and institutionalize attitudes that reduce persons to pigments should at the very least be discouraged. Societies may justifiably limit technologies that are wholly cosmetic while threatening to do harm to innocent bystanders.

In the final analysis, both of these incidents call for the establishment of international standards for reproductive services that draw a line between procedures that are medically appropriate and scientifically compelling, cosmetic but innocuous, or downright dangerous and divisive.

Jonathan Moreno is the David and Lyn Silfen University Professor and Professor of Medical Ethics and of the History and Sociology of Science at the University of Pennsylvania. He is a Senior Fellow at the Center for American Progress and Editor-in-chief of Science Progress.

Tags: bioethics, genetics

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